Healthcare financial management : journal of the Healthcare Financial Management Association
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Healthc Financ Manage · Feb 2002
The HIPAA privacy rule: practical advice for academic and research institutions.
The Final Standards for Privacy of Individually Identifiable Health Information (privacy rule) of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 holds particular importance for academic and research organizations because they use patient information in the provision of experimental healthcare services. In developing a strategy to comply with the final privacy rule, these organizations require an understanding of certain standards that hold significance for them. Specifically, organizations should establish patient privacy guidelines for non-employee researchers the organization should consider partners in business with whom the organization should share its researcher guidelines. These organizations also should understand the difference between consent and authorization, how requirements of the final privacy rule build upon those of the Federal Policy for the Protection of Human Subjects, and the differing roles of privacy boards and institutional review boards.
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Healthc Financ Manage · Oct 2001
The final Stark II rule: implications for hospital-physician arrangements.
Effective January 4, 2002, the final Stark II rule gives hospitals and health systems greater flexibility in structuring compensation arrangements with physicians and physician-owned entities, including more flexibility in structuring employment compensation and providing medical staff perquisites. Further, certain hospital-physician joint ventures are allowed under the final rule. The final rule creates new opportunities for hospitals, but because Stark II remains highly technical and violations can result in potentially substantial financial liability, financial arrangements with physicians should be structured very carefully and reviewed periodically for compliance.
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The Emergency Medical Treatment and Active Labor Act (EMTALA) requires a hospital to provide services to persons who come to the emergency department (ED) for emergency treatment without regard for their ability to pay. Yet some managed care plans require that the hospital obtain authorization before rendering emergency medical treatment, with the result that hospitals risk either nonpayment for services or violation of EMTALA. Hospitals can improve their payment rates for ED care by amending or challenging preauthorization requirements and insisting that plans apply a uniform standard of care to treatment of ED patients.